胸骨后甲状腺肿瘤的外科治疗

Surgical management of substernal thyroid neoplasms

目的:探讨胸骨后甲状腺肿瘤外科治疗的手术入路和围手术期处理方案。方法:回顾分析天津医科大学附属肿瘤医院自2004年1月至2012年10月经手术治疗的104例胸骨后甲状腺肿瘤患者的临床资料。结果:104例患者中,102例通过颈部低位领式切口入路切除,2例患者加用垂直胸骨劈开切口,无手术死亡患者,所有患者中结节性甲状腺肿52例,甲状腺腺瘤41例,甲状腺乳头状癌10例,甲状腺滤泡癌1例。结论:大多数胸骨后甲状腺肿瘤可经颈部低位领式切口入路切除,加强术前影像学检查、娴熟的手术技巧、完善的术后管理可减少手术并发症。

Objective： This work aimed to study surgical approaches and peri-operative management of substemal thyroid neoplasms. Methods： Data of 104 patients with substemal thyroid diseases who have undergone thyroidectomy operation at the Cancer Institute and Hospital since 2004 were retrospectively analyzed. Results： The collar incision in the lower neck was conducted in 102 of the 104 patients. Perpendicular sternal splitting incision was combined with tumor removal in the other two patients. No surgery-related death occurred in all cases. Among all cases, 52 had goiters, 41 had adenomas, 10 had papillary thyroid carcinomas, and 1 had follicular thyroid carcinoma. Conclusion： Most substernal thyroid neoplasms can be removed via cervical collar incision. The improved peri-operative management can reduce complications in cancer patients.